Accepting the last chapter of life……. Helping seniors prepare to move
I decided to write about things you may hear, when trying to help a family member, loved one or friend as you approach the topic of moving from their life long home.
Personally, I have heard every statement listed below. However, I have experienced the joy and relief of seniors and their family members once a decision has been made to move. Most have all acknowledged…. I wish we would have moved sooner, as it went smoother than I thought.
Here are some common concerns shared by many aging seniors:
1. I want to move, but I am overwhelmed with all of my possessions.
Response: Some families help their loved one find a setting and then move things to the new setting. Many times the senior is not able to help make decisions on what to select due to memory, medical or physical care needs. Therefore, family members can reflect on their life lived, and consider selecting “key” items that brought them joy. For some it is an afghan, photographs of family, a special piece of furniture, and their favorite bedding. Some seniors move first, and then deal with selling their home after they are moved. This way the senior is not distracted with having to leave the home often when realtors need to show the home.
2. I want to move, but I don’t know which things to take with me, and what to leave behind.
Response: Try and select the items you will need for easy function in your new space. Assure there is going to be space for any current or future walker/wheelchair needs. Therefore, it is important to make sure the new space is free from excessive clutter.
3. I want to move, but I don’t want to part with any of my things.
Response: I have come to realize that in the last chapter of life, we all must part with some of our things. If the senior can help determine where they want some of their unneeded possessions to go, that is always helpful. Many give to charity programs in their community which help supply furniture etc. to families in need. Many seniors like to know they are now helping someone else get a great start in life. The sentimental items stay in our hearts forever, long after we have parted with the possessions.
4. I want to move, but I don’t want other people going through my possessions.
Response: This is a common emotion for everyone. We tend to our own possessions all of our life. Now, we are in a chapter of life, where we need to find people we trust to assist us in dealing with our possessions. Now is the time to get rid of clothes you have stored, but no longer wear. Now is the time to go through photos, and consider getting them scanned so they can all be on a DVD. If your photos are on a DVD, you can enjoy hours of joy watching your life story on your television.
5. I want to move, but I am afraid my things may be thrown away if no one wants the items, and I don’t have room for them.
Response: It is important to remember that the tastes of your children and grandchildren may not match your tastes. We all collect things we love, and if we enjoyed the items while we had them it is all worth it. So if you don’t have room for the items, consider having a sale, or make a donation to a charity that can use your household items to help others in need. Don’t be easily offended, as this situation is one we will all face in life.
6. I want to move, but I am nervous I won’t be as happy as I have been in my life long home.
Response: No one can ever replace your life long home. It is important to realize that the joy you have in your home comes from the positive energy you bring to the home. You can bring all of your positive energy to your new home. Let’s face it most of us do not like or enjoy change. Most of us are nervous to move whether we are 20, 40, 60, 80, or 100 years of age.
Change is good for us, and sometimes your life long home is truly not in your best interest. Sometimes, making a proactive choice of where you desire to live is the best form of independence. Why?…… Because you made the choice before someone else is forced to make the choice for you related to memory, medical or physical care needs and decline. If you are lucky enough to have another birthday, then realize moving to assisted living, is like going to college. While there are fears, there are great joys. There are other people to stimulate your minds. There are other people to have coffee/tea with and conversation. Your circle becomes bigger than just your family, or community of existing friends. You are never too old to make new friends, and keep the old……. One is Silver and the other is Gold. Somethings you never forget from Girl scouts.
Let your light shine.
Natalie Zeleznikar, CEO
Tips For Dealing With Specific Dementia Problematic Behaviors
By Carrie Steckl, Ph.D.
Agitation – Individuals with dementia frequently become restless, anxious, or upset (when filling out a behavior chart, it is helpful to use specific, concrete words that clearly describe what your loved one is doing so you can truly track whether your changes work to decrease the behavior). To decrease agitation, listen to the person as he or she expresses her frustration to get a clue about what kind of antecedent is a trigger; try to eliminate and/or decrease triggers as much as possible. Pain, discomfort (being too hot, too cold, hungry, needing to use the bathroom, etc.), frustration, and overstimulation are all common triggers of agitation. It is also very important to examine your behavior in response to the person. If you are not already doing so, reassure the person that you are there to provide assistance and comfort. If it seems like the person needs something to do, try redirection to an enjoyable activity.
Aggression – Aggressive behavior can include shouting, cornering someone, raising a hand to someone, or actually pushing or hitting. Unfortunately, aggression among people with dementia can happen suddenly and seemingly without warning. Try to identify what triggered the aggression so that the antecedent can be eliminated or modified as soon as possible. As difficult as it may be, react in a calm, reassuring way and focus on the person’s feelings. Reduce environmental distractions as much as possible, such as loud noises or potentially frightening shadows or movements. Redirecting an aggressive person to an enjoyable activity can be remarkably effective.
Repetition – People with dementia often repeat a word, question, or action over and over again (e.g., saying “What are we doing today?” repeatedly). This behavior is usually harmless, but it can be unnerving and annoying for those who are caring for the person. Repetitive behavior is usually a sign of insecurity, since people with dementia are often looking for something comfortable and familiar – something over which they have some degree of control. To address repetition, look for a specific antecedent or reason for the repetition as well as for the emotion behind it. This can reduce your chances of responding impatiently with the person. If the repetition is an action, try turning it into an activity that makes the person feel useful. For example, if the person is constantly fidgeting with his hands, try giving him some socks to sort or some knick knacks to clean.
Hallucinations – Hallucinations are sensory experiences that seem real, but are not. The most common hallucinations are visual (i.e., seeing something that is not really there) and auditory (i.e., hearing something that is not really there), but hallucinations can also occur in regard to taste, smell, and touch. Because hallucinations seem real to those with dementia, it is not helpful to try to convince the person that she is imagining things. Instead, recognize the person’s feelings, reassure the person that you are there to help, and redirect her to a pleasant activity. Also consider whether the hallucination is actually bothersome. If it is a “nice” hallucination (e.g., seeing a pretty orchard outside that is not really there), there may be no benefit in trying to discourage the behavior.
Suspicion – Memory loss and disorientation can cause individuals with dementia to perceive situations inaccurately. They may become suspicious of others – even those close to them – and accuse them of theft, infidelity, or other offenses. As hurtful as it may be to be accused of something you did not do, try not to become offended. Remember that the behavior is caused by a disease that is affecting the person’s brain. Try to imagine what it would be like to continuously think your possessions are being taken or hidden (because you cannot remember where you put them). Do not try to argue with the person or convince him or her of your innocence. Instead, share a simple response with the person (e.g., “I see that you’re upset that your purse is missing; I’ll do my best to find it for you.”) and avoid giving complicated explanations. Redirection to another activity can also be effective in these situations. Another option is to store “back-ups” of commonly misplaced items (e.g., hats, wallets).
Apathy – Apathy is a lack of interest in or motivation to engage in activities. While apathy may not seem like a serious behavior problem, it is not healthy for someone with dementia to simply sit around passively. Try to find out what may be triggering the apathy (e.g., being ignored or becoming overwhelmed with a task) as well as what kinds of consequences may be reinforcing it (again, being ignored, not having appropriate choices of pleasant activities). Even though the person is ill, it is important to keep him or her moving and as active as possible in order to maintain physical health and to prevent depression. Try adapting previously pleasurable activities so the person can participate at a level that is comfortable and not overwhelming. Even a small amount of activity is better than none at all.
Confusion – Dementia often causes confusion about person, place, and time. In other words, the person may still know who he or she is, but may not recognize others and/or the current location, time, date, or year. An individual with dementia may also become confused about the purpose of objects, such as forks or pens. As frustrating as this can be for caregivers, the best way to respond is to stay calm and provide simple, clear, positive answers when the person asks for help. For example, if the person seems confused about the purpose of a spoon, simply say, “Here’s your spoon for eating your soup.” You could also calmly show the person how to use the utensil (e.g., by saying “watch me”). Never scold the person or talk to him or her in a belittling way for becoming confused.
Sundowning – Sundowning is a term used to describe behaviors that intensify (e.g., increased confusion and agitation) in the late afternoon and early evening, and is most common with Alzheimer’s disease. There are several theories about why sundowning occurs, such as increased fatigue (and as a result, a reduced ability to tolerate stressful situations, such as a chaotic dinnertime or a rushed bedtime routine) or increasing confusion due to darkness and shadows. The best way to approach sundowning is to make late afternoons and evenings as simple and relaxing as possible. Reduce distractions, unscheduled activities, and behaviors that could be done at a different time of the day (e.g., switch to bathing in the morning) and keep rooms well-lit until bedtime.
Wandering – One of the more dangerous behaviors among individuals with dementia, wandering may be goal-directed (e.g., the person thinks that he or she is going to a job or going “home” to a childhood residence) or non-goal-directed (i.e., the person wanders aimlessly). To reduce the frequency of wandering, make sure the person has plenty of supervised activity to channel his or her energy. Redirecting the person to another activity can also work. Interestingly, dementia sometimes affects perception in such a way that environmental approaches can help reduce wandering. For instance, a black square painted on the floor in front of a doorway – or simply a black doormat – may be perceived as a hole, which can prevent the person from leaving the home.